Other antidepressants

Question 1

Other antidepressants - 5 drugs

Answer 1

Bupropion
Mirtazapine
Trazodone
Vilazodone
Hypericin

Question 2

Bupropion - MOA

Answer 2

Weak inhibitor of neuronal reuptake of DOP, NOR, SER at their transporters DAT, NET, SERT.
Noncompetative antagonist at nicotinic cholinergic receptors

Question 3

Bupropion - indications

Answer 3

Adjunct therapy for smoking cessation

Question 4

Bupropion - adverse effects

Answer 4

Agitation, insomnia, nausea, weight loss

Question 5

Mirtazapine - MOA

Answer 5

Antidepressant and antianxiety effects. Blocks presynaptic alpha2-adrenergic autoreceptors and heteroreceptors, causing increased neuronal release of NE and SER respectively. Increases NE levels more than TCAs.
Potent antagonist of 5-HT2 and 5-HT3 receptors.

Question 6

Mirtazapine - adverse effects

Answer 6

Agranulocytosis.

Significant elevation of hepatic enzyme levels

Question 7

Trazodone - MOA

Answer 7

Selectively inhibits the neuronal reuptake of serotonin.

Antagonist at 5-HT2A receptors

Question 8

Trazodone - adverse effects

Answer 8

Considerable sedation and orthostatic hypotension

Question 9

Vilazodone - MOA

Answer 9

Selectively inhibits neuronal reuptake of serotonin. Also partial agonist of 5-HT1A receptors (accounting for anxiolytic effect). Enhancement of serotonergic activity in CNS

Question 10

Tetracyclic antidepressant (TeCA)

Answer 10

Mirtazapine

Question 11

Mood stabilizers - 3 drugs

Answer 11

Lithium
Carbamazepine
Valproate

Question 12

Lithium - Indications

Answer 12

Manic phase of bipolar disorder

Question 13

Lithium - MOA

Answer 13

Reduces both manic and depressive symptoms, but greater activity for manic phase. Suppresses the formation of second messengers involved in SER and NE neurotransmission. Reduces formation of IP3 by inhibiting myo-inositol-1-phosphatase. Interferes with formation of cAMP. Maximal response after days/weeks.

Question 14

Lithium - adverse effects

Answer 14

Neurotoxicity, cardiac toxicity (dysrhythmias). Nausea and vomiting are the earliest signs of overdose.
At therapeutic dose: drowsiness, weight gain, fine hand tremor, polyuria. Hypothyroidism.

Question 15

Lithium - interactions

Answer 15

Renal lithium clearance increases during pregnancy.
Sodium competes with lithium for tubular reabsorption increased excretion of lithium.
NSAIDs and diuretics increase serum levels.

Question 16

Valproate - indications as mood stabilizer

Answer 16

Rapidly cycling of manic and depressive episodes & pts with coexisting substance abuse